Some mental health professionals say that the anonymity and physical distance provided by IM actually helps patients, especially those dealing with difficult issues such as sexual abuse. Encrypted chats are also more confidential and private than phone consultations (one could even engage in a session from his or her cubicle at work). Supporters of e-therapy claim that it reaches a population that would not seek help otherwise. "No one can see you, and because they can't see you, people don't have the impression that they're being judged," says Barry Karlin, CEO of CRC Health Group, which runs eGetGoing.

Others, though, argue that IM is no substitute for face-to-face therapy, where mental health professionals can "read" patients' facial cues and body language. Nearly all mental health experts agree, though, that IM should not be used to treat severely disturbed or suicidal patients.

Many of the e-therapy services accept health insurance, and offer services ranging from life coaching to marriage counseling to smoking cessation. Fees can range anywhere from $60 to $120 per hour, and though largely unregulated, e-therapy sites claim to have a high success rate (or, at least, a high completion rate of their programs).

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